Discontinuation rates within the first year are consistently reported between approximately 45 and 75% (Sikirica et al., 2017
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Signs of thyroid problems (neck swelling, difficulty swallowing, persistent hoarseness) require prompt medical review Symptoms of gallbladder disease (right upper quadrant pain, jaundice, fever) Acute kidney injury symptoms (marked reduction in urine output, swelling, confusion), which can occur secondary to severe dehydration A comprehensive clinical assessment should include review of blood glucose monitoring, assessment for anaemia (full blood count), thyroid function tests, renal function, and evaluation of nutritional status
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